Individual ProviderSamantha HaongStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address19555 N 59th Ave, Glendale, AZ 85308-6813(623) 572-3200PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Haong does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1295618510Provider TypeIndividualFull NameHaong, SamanthaCredentialMEDICAL STUDENTSole ProprietorYesEnumeration Date7/26/2025Last Updated7/26/2025Contact InformationPractice LocationPractice Address19555 N 59th Ave, Glendale, AZ 85308-6813Phone(623) 572-3200FaxUnlisted FaxMailing LocationMailing Address19555 N 59th Ave, Glendale, AZ 85308-6813PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer